COMMUNICATION SKILLS FOR PATIENT-CENTERED CARE

Abstract

Better physician-patient communication is linked to increased patient satisfaction and patient adherence to medication and treatment regimens as well as to improved clinical outcomes1-4. Practicing orthopaedic surgeons have received limited formal education in the communication skills necessary for patient-centered care; yet, we perform over 100,000 medical interviews during our careers5. Patient-centered care involves treating patients as partners, involving them in decision-making, and enlisting their sense of responsibility for their care while respecting their individual values and concerns6,7. We have tended to focus mainly on the technical aspects of our care-giving8. We do not seem to be very good communicators9,10. In 1998, the American Academy of Orthopaedic Surgeons (AAOS) conducted an extensive national survey to which 807 patients and 700 orthopaedic surgeons responded11. The patients and surgeons were asked to rate orthopaedic surgeons with use of the same categories. Patients rated technical skills as important (“hightech”) but valued communication skills equally (“high-touch”)12 (Table I). According to this survey, 75% of the orthopaedic surgeons believed that they communicated satisfactorily with their patients, but only 21% of the orthopaedic patients reported satisfactory communication with their physicians. This gap was most evident in categories such as listening and caring and time spent with the patient9. Our most common deficiency in our daily interviews with patients remains a failure to demonstrate an empathic response13. View this table: TABLE I Discrepancies Between AAOS Members' Self-Assessment and Patients' Perceptions of Orthopaedic Care12 We can all learn to communicate better. During the past twenty years, effective tools for teaching and assessing physician communication skills have been developed. Communication skills are being taught in medical schools and residency programs2,8,14-16. Beginning with the …